Comparison of Pregnancy Associated Plasma Protein a Levels in Pregnant Women with and without Intra Uterine Growth Retardation Referring to the Al-Zahra Hospital during the Year 2016

Background: Maternal serum markers, including pregnancy associuted plasma protein a (PAPP-A), are associated with adverse pregnancy outcomes such as aneuploidy, fetal growth restriction, preeclampsia, fetal death, and preterm labor. PAPP-A is a valuable element to predict the risk of adverse pregnancy complications. PAPP-A is different in races and papulations. The aim of this study was to A comparative study between pregnancy-associated plasma protein-A in pregnant women with and without IUGR referred to Alzahra Hoaspital of Rasht in 1396.Methods: In this comprative cross-sectional study, 227 pregnant women referring to Alzahra Hospital in Rasht for lable un 1396 were evaluated. The mothers were divided into two main groups. The first groups that have a definitived diagnosis of IUGR after delevery Based on the Weight of infants and gestational age (percentile growth < 10%) including 76 peaple and the second group those who did not have infants with IUGR including 151 peaple. Data include age, weight, height, PAPP-A concentration, type of delivery, gestational age, birth weight, preeclampsia, gestational diabetes, Apgar score & existeince or absence of intrauterine growth restriction registered on special forms. Serum PAPPA level which is one of the first there months screening components was compared in these two groups. Data were analized by SPSS version 21.Results: The mean age of the studied samples was 28.8 ± 5.6 years. The mean number of pregnancies was 0.93 ± 1.7 and the mean weight gain was 12.6 ± 4.9 kg. 2.2% of the samples had a history of stillbirth and 70.9% had cesarean delivery. 33.5% had IUGR. 96.5% of samples had normal amniotic fluid status. In Apgar scores, the majority (46.5%) had the Apgar score of 8 in the first minute and the remaining samples (54.2%) had Apgar score 9 in the fifth minute. The mean neonatal weight was 2646.8 ± 641 gr. The mean PAPPA in subjects without IUGR was 0.48 ± 1.02 with a middle of 1 and in subjects with IUGR was 0.78±0.49 with a middle of 0.64 and statistically significant, so that the level of this protein even after controlling interventionist factors was lower in subjects with positive IUGR. PAPPA levels were significant in the positive and negative IUGR group. In this study cut off point for PAPPA was 0.73 with a sensivity of 72% and specialty of 60%.Conclusion: Our findings confirm that there is a significant relationship between pregnancy outcomes specially IUGR and low levels of PAPP-A in mothers. Mothers with low PAPP-A require more care and preventive measures to prevent complications due to intru uterin growth retardation. In this study cut off point of PAPPA related to IUGR was 0.73 which was higher than other studies in others countries which could be due to recial differences and other characteristics of the population studied.

کلیدواژه ها:

Pregnancy-Related Plasma A Protein (PAPP-A) ، IUGR